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Individual

CHARLES W BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1326 EISENHOWER DR BLDG 1, SAVANNAH, GA 31406-3928
(912) 691-4200
(912) 303-3506
Mailing address
PO BOX 6247, SNOWMASS VILLAGE, CO 81615-6247
(843) 816-4549

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
028509
GA
2085R0202X
Diagnostic Radiology Physician
19165
SC
2085R0202X
Diagnostic Radiology Physician
48081
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000321087G
GA
05
10025709000
NE
05
1285686766
MT
05
1285686766
WY
05
200627500A
KS
05
474618
AZ
05
47706252
NM
01
52237053005
BCBS
GA
05
84059792913
NE
05
84089712600
NE
05
85588555
CO
01
CO305925
MEDICARE MIC
CO
01
CO305926
MEDICARE RIA
CO
01
N355708
WELLCARE
GA
01
P00347630
RR MEDICARE
01
P00760022
RR MCR MIC
CO
Enumeration date
05/16/2006
Last updated
08/05/2022
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